Judie Birns has seen people go from handcuffs to graduation caps in the drug treatment court she manages in Regina.
“[Some] are working in the [social work] field now — that’s huge in terms of success,” said Birns.
Birns is part of a growing movement across Canada to offer treatment — not jail time — to people facing criminal charges linked to substance use.
Drug treatment courts aim to break the cycle of addiction and incarceration by integrating treatment into the justice system — offering people the choice between pursuing recovery and a prison sentence.
“In 2005 … people were circulating through the courtrooms on a regular basis, all related to addiction,” said Birns, referencing the year before Regina’s Drug Treatment Court opened.
“It was like a revolving door.”
Not everyone is a proponent, however. A number of independent reviews of drug treatment courts have raised questions about their effectiveness.
Drug Treatment Court
Ontario was the first province to launch a drug treatment court when it opened the Toronto Drug Treatment Court in 1998. The court was a collaboration of the provincial courts, the federal justice department and the Centre for Addiction and Mental Health, Canada’s leading mental health research centre.
That court — and subsequent ones — aim to divert first-time, non-violent offenders of addiction-related crimes into supervised treatment programs, rather than sentencing them to jail.
“[W]e are strengthening our justice system and helping people get the care they need to recover, break the cycle of drug use, and prevent criminal reoffending,” federal Justice Minister Sean Fraser said in a July 9 press release announcing the new Battlefords Drug Treatment Court in west-central Saskatchewan.
The Department of Justice helps fund drug treatment courts, which the provinces administer. Federally supported courts currently operate in B.C., Alberta, Saskatchewan, Manitoba, Ontario, Quebec and Newfoundland and Labrador.
To participate in a drug treatment court program, an accused is required to plead guilty to their criminal charges. They then receive individualized recovery support, including counselling, addiction treatment and social services.
To graduate, they must have remained sober throughout the program, which typically lasts about 12 months. Successful graduates often receive a reduced sentence or discharge, meaning they avoid a criminal record.
Individuals are typically ineligible to participate if they have a violent history, have been charged with commercial drug trafficking or endangering others, or are linked to gangs or criminal organizations.
Program expansion
Provincial officials say the expansion of drug treatment courts nationwide is a reflection that they work.
Birns, of Regina’s Drug Treatment Court, says many participants initially agree to join the program to avoid going to jail. But she has seen some people undergo genuine transformations in the program.
“A number of them have told me, ‘I just wanted to get out of jail. But then I met somebody in the program that I used to use with who was four months clean, and it gave me the hope that maybe I could do that’,” said Birns.
“They find that they start to fit in, and they want to make that change. But they’ve never actually been provided all the resources in one spot.”
According to Karri Ward-Davis, a communications consultant for Saskatchewan’s Ministry of Justice, since 2006, 156 people had graduated from the province’s drug treatment courts as of June 2025. But an overall completion rate is not available, she says.
“Participants often complete different tracks of Drug Treatment Court at different times,” she said.
Evaluation
However, independent evaluations of Canada’s drug treatment courts paint a mixed picture of their effectiveness.
A 2009 Department of Justice evaluation found wide variation in graduation rates across provincial courts, ranging from a low of six per cent in Toronto to a high of 36 per cent in Winnipeg.
The provinces’ own assessments reveal similarly large disparities. The Alberta Court of Justice reports about 80 per cent of participants graduate from its program, while a Toronto Drug Treatment Court evaluation put its graduation rate at just 16 per cent.
A 2023 review by the Canadian Centre on Substance Use and Addiction suggests that wide variances in the support services courts offer may be a factor.
The review found that courts serving rural and Indigenous communities often lack critical supports. Supports such as public transit, stable housing and specialized practitioners are critical for addressing substance use disorders, improving treatment retention and reducing reoffending.
The requirement that participants not use drugs in the program can also complicate treatment efforts. Some drug treatment courts do not allow use of medications that treat opioid use disorder, such as methadone or Suboxone — even though research shows they reduce drug use and reoffending.
“[C]ourt officials are reluctant to view [these medications] as acceptable in an abstinence-based program and view these medications as replacing one addictive drug for another,” the review says.
Similarly, a 2011 assessment for the Canadian HIV/AIDS Legal Network raised ethical concerns about requiring participants to plead guilty before entering a program. This leaves unsuccessful participants with both a conviction and an untreated addiction.
Forcing a guilty plea “to gain access to health services and medical treatment” undermines participants’ rights and exposes them to “serious health consequences,” the assessment says.
Return on investment
Birns says Saskatchewan has not measured the long-term outcomes of its drug treatment courts. But she says they have observed success stories.
“We look for lifestyle changes. We look for not seeing them in court all the time,” she said. “The judges can tell by who they’re not seeing in the courtrooms.”
Saskatchewan’s three drug treatment courts — in Regina, Moose Jaw and North Battleford — emphasize a comprehensive approach that addresses the full spectrum of participants’ needs, she says.
“When you stop using drugs, things start to hurt. They’ve been medicating a lot of pain and discomfort, physically and mentally, for years using drugs,” said Birns.
“We’re looking after their mental health, their physical health. They’re getting glasses, they’re getting their teeth done.”
According to Ward-Davis, of the Saskatchewan Ministry of Justice, there are many qualitative indicators of success.
“Working with expectant mothers has resulted in eight clean babies who are drug free at birth since the program started,” she told Canadian Affairs.
“Several current program participants are in the process of regaining custody of their children.”
Although full sobriety is needed to graduate, Saskatchewan’s program also recognizes meaningful progress among those who have relapsed but have stopped offending and significantly reduced their drug use. It awards Certificates of Achievement in such cases.
Both graduates and non-completers report stronger family relationships, better housing and employment, according to Ward-Davis.
“People are reuniting with their children, they’re going to school, they’re getting an education or work,” said Birns.
“Just because you didn’t graduate doesn’t mean you didn’t change.”
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